Endocrinol Metab.  2023 Dec;38(6):669-678. 10.3803/EnM.2023.1734.

Age-Dependent Association of Height Loss with Incident Fracture Risk in Postmenopausal Korean Women

• Lee C
• Park HS
• Rhee Y
• Hong N

• KMID: 2549260
• DOI: http://doi.org/10.3803/EnM.2023.1734

Abstract

Background
Height loss is a simple clinical measure associated with increased fracture risk. However, limited data exists on the association between height loss and fracture risk in postmenopausal Korean women. It is unknown whether this association varies with age.
Methods
Data on height loss over a 6-year period were collected from a community-based longitudinal follow-up cohort (Ansung cohort of the Korean Genome and Epidemiology Study). Incident fractures were defined based on self-reported fractures after excluding those due to severe trauma or toes/fingers. The association between incident fractures and height loss was investigated using a Cox proportional hazards model.
Results
During a median follow-up of 10 years after the second visit, 259/1,806 participants (median age, 64 years) experienced incident fractures. Overall, a 1 standard deviation (SD) decrease in height (1.6 cm/median 5.8 years) was associated with 9% increased risk of fracture (hazard ratio [HR], 1.09; P=0.037), which lost statistical significance after adjustment for covariates. When stratified into age groups (50–59, 60–69, 70 years or older), a 1 SD decrease in height remained a robust predictor of fracture in the 50 to 59 years age group after adjusting for covariates (adjusted hazard ratio [aHR], 1.52; P=0.003), whereas height loss was not an independent predictor of fracture in the 60 to 69 (aHR, 1.06; P=0.333) or the 70 years or older age groups (aHR, 1.05; P=0.700; P for interaction <0.05, for all).
Conclusion
Height loss during the previous 6 years was associated with an increased 10-year fracture risk in postmenopausal women in their 50s.

Keyword

Body height; Fractures, bone; Cohort studies

Figure

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  Fig. 1. The flowchart of the study population from the Korean Genome and Epidemiology Study (KoGES). QUS, quantitative ultrasound.

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  Fig. 2. The fracture incidence rate according to the age group and height loss. Age, body mass index, and speed-of-sound at the midshaft tibia were adjusted.

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  Fig. 3. Kaplan–Meier curve for incident fracture-free survival. (A) Overall population, aged (B) 50–59, (C) 60–69, and (D) 70 years or older.

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  Fig. 4. Forest plot of fracture risk according to height loss with age subgroups. CI, confidence interval.

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